Kornimate/medical-research-clean huggingface dataset:
follow-up of low-acuity patients after redirection from a swiss emergency department using an electronic triage application

Conditions: Triage; Low Acuity Patients; Health Literacy Level; Non-urgent Emergencies

Summary: emergency department (ed) overcrowding is a growing issue, affecting patient safety, healthcare quality, and hospital efficiency. one strategy to manage low-acuity patients is triage-based redirection, where patients with non-urgent conditions are offered the option to receive care at external medical facilities instead of the ed. this monocentric, prospective observational study will be conducted at fribourg cantonal hospital, switzerland, and evaluates the impact of a new electronic triage and redirection system (logibec réorientation). the study compares two triage processes: current practice - redirection based on the swiss emergency triage scale (sets), limited to low-acuity patients (sets 4). new practice - redirection using the logibec software, allowing redirection of both low-acuity (sets 4) and semi-urgent (sets 3) patients based on predefined criteria. the primary objective is to assess whether the new triage-based redirection reduces the number of ed consultations per patient within 48 hours of their initial visit. secondary outcomes include: number of consultations in the ed or other medical facilities within 7 days rate of hospital admissions within 7 days patient satisfaction with redirection evolution of health literacy over 6 months number of ed visits over 6 months participants are adult patients (≥18 years old) classified as sets 3-4 and identified as eligible for redirection by the logibec software. data will be collected through phone interviews and questionnaires over a 6-month follow-up period. this study aims to improve triage efficiency, patient flow management, and healthcare accessibility, while ensuring patient safety in the redirection process.


Eligibility criteria:
inclusion criteria: * age ≥18 years old * triage level sets 3 or sets 4 (classified as semi-urgent or low-acuity) * identified as eligible for redirection by the logibec electronic triage system * able to speak and read french or german (for informed consent and follow-up) * provides informed consent: oral consent at day 2 and signed informed consent sent by post after inclusion exclusion criteria: * inability to provide informed consent (e.g., cognitive impairment, language barrier without translation support) * inability to comply with study procedures, such as: severe hearing impairment without hearing aids; acute psychiatric conditions preventing participation; not available for follow-up phone calls within the next 6 months

Keywords: patient satisfaction emergency department triage patient redirection healthcare system efficiency referral and consultation electronic decision support tool patient flow emergency overcrowding
heart failure with normal ejection fraction (hfnef) in hemodialysed patients: beneficial effect of ivabradine

Conditions: Heart Failure

Summary: heart failure with normal ejection fraction is often under diagnosed and certainly under treated in hemodialyzed patients. because of the benefit of reducing heart rate, ivabradine, a pure heart-rate lowering agent without effects on blood pressure, is of potential therapeutic utility.


Eligibility criteria:
inclusion criteria: * hemodialyzed patients * signs and symptoms of heart failure with normal ejection fraction * sinus rhythm exclusion criteria: * atrial fibrillation/atrial flutter * valvular heart disease * unstable angina * hospitalization for heart failure prior 3 months

Keywords: heart failure with normal ejection fraction hemodialysis patients ivabradine echocardiography nyha class 6-minutes walking test
mri in pre-operative radiotherapy for soft tissue sarcoma: mists study

Conditions: Sarcoma

Summary: this study will use diffusion weighted mri (dwi mri) and dynamic-contrast enhanced mri (dce mri) techniques to detect changes in sarcoma tumour vasculature. the main aims of this study are to correlate histological response of soft tissue sarcoma after pre-operative radiotherapy with several pre-treatment dce and dwi mri parameters and to assess the impact of these on early response prediction. detected changes may reflect the sensitivity of the tumour to radiotherapy and may be associated with long term outcomes after treatment. 15 patients normally having pre-operative radiotherapy as part of their sarcoma treatment will be recruited to this study. patients will have an additional three specialised mri scans: one prior to the start of radiotherapy, one during the second week of radiotherapy while on treatment and one scan a week before surgery but after the completion of radiotherapy. post-operatively, results of the histological examination of the sarcoma will be correlated to both the mri scan data and outcomes after treatment


Eligibility criteria:
inclusion criteria: * patients must have histologically confirmed diagnosis of intermediate/high grade soft tissue sarcoma (sts) * patients must be suitable for treatment with preoperative radiotherapy and radical surgery * standard radiological assessments (ct or mri) may have already been performed but must be done within 4 weeks of starting radiotherapy * patient must have measurable disease on ct/mri imaging * ecog performance status 0-2 * adequate pre-treatment haematological and biochemical parameters * age greater than or equal to 18 years * no significant co-morbidity thereby excluding patient from having radical treatment. * no previous treatment for diagnosis of sts including neo-adjuvant chemotherapy * women of child bearing age must have a negative pregnancy test prior to study entry and be using an adequate contraception method unless child bearing potential has been terminated by surgery/radical radiotherapy * patients must have given written informed consent exclusion criteria: * patients with cardiac pacemakers, cochlear implants, intraocular foreign bodies or any other mri incompatibility factors (e.g. recent surgery). * patients with a known history of anaphylactic reaction to contrast material for mri * previous administration of gadoxetic acid or other contrast material 24hr prior to or after the mri * any evidence of severe or uncontrolled systemic diseases which, in the view of the investigator, makes it undesirable for the patient to participate in the trial * evidence of significant clinical disorder or laboratory finding which, in the opinion of the investigator makes it undesirable for the patient to participate in the trial * any other serious uncontrolled medical conditions * clinical evidence of metastatic disease * any pregnant or lactating woman * any patient with a medical or psychiatric condition that impairs their ability to give informed consent * evidence of impaired renal function, serum creatinine \>1.5x upper limit of normal
prevention and control of healthcare-associated infections

Conditions: Nosocomial Infection

Summary: bundling infection control interventions should decrease incidence of healthcare-associated infections in general medical wards at siriraj hospital, bangkok, thailand


Eligibility criteria:
inclusion criteria: * the patients hospitalized to general medical wards exclusion criteria: * the patients hospitalized less than 48 hours
an open-label, 18fdg-pet pharmacodynamic assessment of the effect of biib021 in subjects with gastrointestinal stromal tumors (gist)

Conditions: GIST

Summary: this study will examine the effect of biib021 on gist growth and metabolism.


Eligibility criteria:
inclusion criteria: * ability to understand the purpose and risks of the study and provide signed and dated informed consent and authorization to use protected health information (phi) in accordance with national and local subject privacy regulations. * age greater than or equal to 18 years at the time of informed consent. * pathologically confirmed gist refractory to, intolerant of, or not a candidate for imatinib and sunitinib therapy. * fdg pet standard uptake value (suvmax; averaged over a maximum of 5 lesions) greater than or equal to 2 at screening. * ecog performance status of less than or equal to 2. * lab values consistent with adequate renal hepatic and bone marrow function. * must utilize effective contraception. exclusion criteria: * prior treatment with imatinib, sunitinib, or sorafenib with in 14 days of day 1. * prior treatment with hsp90 inhibitors at any time. * prior antitumor therapies including prior experimental agents, approved antitumor small molecules (excluding imatinib, sunitinib, or sorafenib) and biologics, or radiotherapy with in 28 days or \<3 half lives (whichever is longer) before start of biib021treatment. * diabetes treated with insulin and/ or concurrent severe or uncontrolled other medical disease (i.e, systemic infection, hypertension, coronary artery disease, congestive heart failure). * history of/ or predisposition to seizures.
patient controlled remifentanil analgesia for normal labour

Conditions: Labor Pain; Full Term Pregnancy

Summary: patient controlled remifentanil analgesia might offer comparative overall patient satisfaction and improved quality of analgesia after normal labour with continuous epidural analgesia.

we are aiming to study the effects of patient controlled remifentanil analgesia and epidural analgesia for normal labour in full term parturients on: * peripartum analgesia * overall patient's satisfaction * maternal adverse effects * neonatal outcomes

Eligibility criteria:
inclusion criteria: * gestational age \> 36 weeks * american society of anesthesiologists physical class i to iii exclusion criteria: * allergy to study solution * contraindications to epidural analgesia * non consented parturients * communications barriers. * intrauterine foetal growth retardation * foetal distress
investigation of genetic determinants of capecitabine toxicity

Conditions: Breast Cancer

Summary: the purpose of this study is to identify possible genetic polymorphisms that contribute to specific toxicities associated with capecitabine (hand-foot syndrome, diarrhea, and neutropenia). additionally, this study will look at gene polymorphisms in patients experiencing the toxicities of interest, the frequency of polymorphisms and differences in drug metabolism.


Eligibility criteria:
inclusion criteria: * women with breast cancer in whom single agent capecitabine therapy is being considered * aged 18 years and older exclusion criteria: * patients who have previously received capecitabine are excluded * patients cannot be receiving capecitabine in combination with another cancer chemotherapy; concurrent use of trastuzumab is not permitted; concurrent use of zoledronic acid is allowed * serum albumin less than 3.0 g/dl within the last 30 days * creatinine clearance (crcl) or glomerular filtration rate (gfr) less than 60 ml/min \[/body surface area (bsa)\] (within the last 30 days) * inability to understand and give informed consent to participate * patients with a history of inflammatory bowel disease requiring therapy or patients with chronic diarrhea syndromes or paralytic ileus * patients with prior or concurrent pelvic irradiation * patients who use an ostomy for fecal excretion * there is no limit on the number of prior chemotherapies; the decision to use capecitabine is determined solely by the treating physician

Keywords: breast cancer capecitabine
promri icd/crt-d post approval study

Conditions: Tachyarrhythmia

Summary: following product approval, confirmation of appropriate vf episode detection after mri exposure of the promri icd/crt-d systems and to evaluate left ventricular pacing threshold changes post-mri.


Eligibility criteria:
inclusion criteria: * promri icd/crt-d system enabled with biotronik home monitoring. exclusion criteria: * none
welchol® with metformin in treating patients with type 2 diabetes

Conditions: Type 2 Diabetes

Summary: the purpose of the study is to see how safe and effective and tolerable the use of colesevelam hydrochloride is for type 2 diabetes when added to metformin alone or in combination with other anti-diabetic drugs.


Eligibility criteria:
inclusion criteria: * age 18-75 years, inclusive * diagnosed with type 2 diabetes * hemoglobin (hba1c) between 7.5% to 9.5% * prescribed an ada accepted diet * receiving stable dose of metformin alone or in combination with other oral anti-diabetic medications for 90 days before visit 1 exclusion criteria: * history of type 1 diabetes or ketoacidosis * history of chronic (more than 2 months) insulin therapy or the initiation of insulin for chronic treatment * history of pancreatitis * uncontrolled hypertension * recent severe cardiovascular disease * allergy or toxic response to colesevelam or any of its components * body mass index (bmi) \>45 kg/m2

Keywords: diabetes mellitus
a comparison of two standard therapies in the management of dementia with agitation

Conditions: Senile Dementia, Alzheimer Type; Dementia, Alzheimer Type; Alzheimer Disease; Dementia

Summary: the purpose of this study is to determine whether an antipsychotic medication alone or an antipsychotic medication in combination with divalproex is the most effective and safest way to treat agitation in elderly patients with dementia.

previous researchers have attempted to establish a "target dose" for antipsychotic medications (such as risperidone, quetiapine, or olanzapine) in treating symptoms of agitation in dementia. they have tried to identify the dose with the best risk-benefit ratio for patients considering the significant side effects the medications can cause. patients taking the doses identified respond only partially and continue to experience some symptoms of agitation, however. one study showed that in patients whose agitation symptoms were not adequately controlled by the target dose of an antipsychotic medication alone, the addition of divalproex further improved behavior in 72% of patients. the goal of this study is to compare two standard therapies for the management of agitation symptoms in dementia patients. subjects in this study will include patients who are admitted to the wesley woods inpatient service for the treatment for dementia complicated by behavioral symptoms. after a patient reaches the target dose of risperidone (up to 1.5 mg/day), quetiapine (up to 175 mg/day), or olanzapine (up to 7.5 mg/day) and agitation symptoms are still not adequately managed, he or she will be randomized to one of two groups. group 1 participants will continue to receive increasing doses of antipsychotic medication until symptoms are controlled or he or she is unable to tolerate the dose. group 2 participants will continue to receive the target dose of antipsychotic medication and also receive increasing doses of divalproex until symptoms are controlled or he or she is unable to tolerate the dose. patients will be evaluated at 4 time points during hospitalization. patients will be evaluated using scales that measure changes in cognition, function, and behavior. laboratory and ecg results, and scales testing for movement disorders will be done to monitor safety. the family will then be contacted about 3 months the patient's hospitalization to assess current treatment status, residential status, and health status.

Eligibility criteria:
inclusion criteria: * inpatients admitted to wesley woods inpatient service for dementia with psychosis and agitation; taking risperidone (up to 1.5 mg/day), quetiapine (up to 175 mg/day), or olanzapine (up to 7.5 mg/day) exclusion criteria: * prior sensitivity to risperidone, quetiapine, olanzapine or divalproex

Keywords: alzheimer's disease geriatric dementia agitation behavioral disturbances psychosis
improving informed consent process for percutaneous cholecystostomy in the emergency department

Conditions: Cholecystitis

Summary: this study is planning to develop the audiovisual videos and determine whether educational videos are superior to routine discussion for informing patients in the emergency department (ed) about risks, benefits, and alternatives to receiving percutaneous cholecystostomy. eligible patients will be approached when patients will be scheduled and waiting for receiving percutaneous cholecystostomy in the emergency department.


Eligibility criteria:
inclusion criteria: * all patients 18 years of age or older * scheduled to receive the percutaneous cholecystostomy exclusion criteria: * clinically unstable * refuse to participate * are unable to understand the study process
cardiovascular status in adrenal insufficiency

Conditions: Adrenal Insufficiency

Summary: within this trial, the cardiovascular status and metabolic profile of patients with chronic primary adrenal insufficiency is evaluated.

an unfavorable metabolic profile in patients with adrenal insufficiency (ai) under hormone replacement therapy with hydrocortisone (hc) has been revealed in one recent analysis. furthermore an increased cardiovascular (cv) morbidity in ai is assumed. the aim of the study is to evaluate the metabolic profile and cardiovascular status in patients with primary ai. patients with primary ai under standard replacement therapy with hc undergo detailed cv evaluation (including e.g. laboratory test, analysis of endothelial function, 24h blood pressure profile, holter ecg, echocardiography and cardiac mri).

Eligibility criteria:
inclusion criteria: * chronic primary adrenal insufficiency * adequate hormone replacement therapy (\>3 years) * age \>18 years * patient's informed consent exclusion criteria: * hormone replacement therapy with an other glucocorticoid than hydrocortisone * pharmacotherapy with glucocorticoids * congenital adrenal hyperplasia * coronary heart disease * heart failure * systemic disease with (potential) cardiac involvement (e.g. amyloidosis, lung fibrosis) * pregnancy * chronic alcohol abuse * malignant disease * arterial hypertension * chronic renal failure (mdrd \<60)

Keywords: primary adrenal insufficiency cardiovascular status metabolic profile
comparison of effectiveness of alexander technique versus feldenkrais technique in non - specific neck pain patients

Conditions: Neck Pain

Summary: comparison of effectiveness of alexander technique versus feldenkrais technique in non - specific neck pain patients

the proposed synopsis aims to compare the effectiveness of alexander technique nd feldenkrais technique in alleviating non spicific neck pain. both at and ft are somatic education methods focusing on improving body awareness and movement patterns. the study will involve non - specificc neck pain paytients randomly assigned to either at or ft intervention groups outcome measures will include pain intensity, posture, functional ability and quality of sleep. data will be collected at baseline, post - interventrion and on follow up to assess the short term and long term effects. statistical analysis will be conducted to determine differences in outcomes between the two groups. understanding the comparitive effectiveness of at and ft could provide valuable insights for healthcare professionals in choosing appropriate intervention for non - specific neck pain patients management.

Eligibility criteria:
inclusion criteria: * both male and female patients * patients who have compromised activity of daily living due to neck pain * patients with non - specific neck pain * patients aging from 20 to 25 years exclusion criteria: * patients with diagnose dneck pathologysuch as cervical disc herniation and spondylosis etc. * patients who are unable to participate in any physical activity * patients with recent neck injury or trauma * patients with cognitive impairment
study of ribociclib with everolimus + exemestane in hr+ her2- locally advanced/metastatic breast cancer post progression on cdk 4/6 inhibitor.

Conditions: Breast Cancer

Summary: the purpose of this study is determine if the triplet combination of ribociclib, everolimus and exemastane is safe and effective in the treatment of locally advanced/metastatic breast cancer following treatment with a cdk 4/6 inhibitor

this trial had two phases. the purpose of phase i dose escalation and dose de-escalation was to determine the maximum tolerated doses (mtds) and/or identify the recommended phase ii dose (rp2d) of the combination treatment of ribociclib+ everolimus + exemestane. the dosing was continuous in adult men and postmenopausal women with hr+ her2-negative advanced breast cancer which was resistant to the non-steroidal aromatase inhibitors, fulvestrant or tamoxifen. the purpose of the phase ii portion of this trial was to evaluate the anti-tumor activity of exemestane, everolimus and ribociclib combination therapy following progression on a cdk 4/6 inhibitor. the planned duration of the study was 30 months.

Eligibility criteria:
inclusion criteria: * adult men and women * patient has a confirmed diagnosis of estrogen-receptor positive and/or progesterone receptor positive breast cancer by local laboratory and has her2-negative breast cancer * patient must have either measurable disease by recist 1.1 or bone lesions in absence of measurable disease. * ecog performance status 0 - 1 * disease refractory to either, ai, tamoxifen or fulvestrant * previously treated on any cdk 4/6 inhibitor. * patient has adequate bone marrow and organ function. exclusion criteria: * patient with symptomatic visceral disease or any disease burden that makes the patient ineligible for endocrine therapy per the investigator's best judgment. * patient has received more than one line of chemotherapy for advanced disease. * previous treatment with mtor inhibitors, or exemestane for advanced disease. * progressed on more than one cdk 4/6 inhibitor * patient with cns involvement unless they are at least 4 weeks from prior therapy completion. * clinically significant, uncontrolled heart disease and/or recent cardiac events.

Keywords: hr-positive her2-negative advanced breast cancer lee011 ribociclib everolimus afinitor exemestane aromasin cdk cdk4 cdk6 cdk4/6 cdk4/6 inhibitor phase i phase ii er-positive pr-positive postmenopausal adult
a study of ips cell-derived cardiomyocyte spheroids (hs-001) in patients with heart failure (lapis study)

Conditions: Heart Failure; Ischemic Heart Disease

Summary: the purpose of this clinical study is to evaluate the safety and efficacy of hs-001 cs transplanted into severe heart failure patients with underlying ischemic heart disease for 26 weeks after transplantation.

this is a multicenter, open-label, two-group dose-escalation, phase i/ii study in 10 severe heart failure patients (five in the low-dose group and five in the high-dose group) with underlying ischemic heart disease. after screening period is completed, subjects undergo hs-001 cs transplantation. after transplantation, subjects take immunosuppressant and have efficacy/safety assessments.

Eligibility criteria:
inclusion criteria: * patients with resting left ventricular ejection fraction (lvef) ≦40% based on institutional assessment on either screening cardiac mri or echocardiographic assessment * new york heart association (nyha) cardiac function classification of grade ii or higher at screening * other criteria apply, please contact the investigator exclusion criteria: * patients screened less than 1 month after the onset of myocardial infarction * patients with congenital heart disease, or cardiac sarcoidosis * other criteria apply, please contact the investigator

Keywords: heart failure ischemic heart disease